CLINICAL MANAGEMENT OF TRAUMATIC WOUND WITH MAGGOTS ON THE HEAD OF A DOG

Amarjit Karam*, Koushik Kakoty, Nripendra Mahanta, Raju Kumar Dewry, Manoj Kumar
Kalita, Rojesh Khangembam, Sanjana Bora and Arnab Sen
*Scientist, Division of Animal Health, ICAR-Research Complex for NEH Region, Umiam (Meghalaya), India. [Received: 24.2.2018; Accepted: 27.8.2018] {DOI 10.29005/IJCP.2018.10.2.110-111}

An eight years old male dog weighing 20 kg was presented in the Division of Animal Health, ICAR, Umiam
(Meghalaya) with a history of being bitten by another dog while fighting. Clinical examination revealed extensive
wound with maggots on the head. Successful treatment of traumatic wound with maggots on the head was attempted after debrimentation and removal of the maggots from the wound by applying Turpentile oil in the wound and simultaneously injecting Ivermectin @ 0.3mg/kg body weight subcutaneously followed by general wound care management which includes broad spectrum antibiotic therapy (Ceftriaxone @ 25mg/kg body weight), Meloxicam injection, topical antiseptic dressing with povidone iodine solution and topical application of fly repellent. Keywords: Dog, Head, Maggots, Traumatic wound.

Traumatic wounds are typically defined as cuts, lacerations or puncture wounds which have caused damage to both
the skin and underlying tissues. Although head trauma occurs less commonly in dog due to the thicker skull with more muscle mass however it is a very serious condition. Traumatic wound on head can result from a variety of injuries in dogs as biting by another dog while fighting is a common cause of head injury in dog. In fact, bite wounds are one of the most common reasons for hospitalization of dogs and cats in veterinary clinics (Holt and Griffin, 2000 and Kelly et al., 1992). Fly species that normally breed in meat or carrion can become attracted to necrotic tissue odors and colonize pre-existing wounds resulting in a type of facultative cutaneous myiasis, often
called wound myiasis (Day et al., 2000). Left untreated, maggot wounds are fatal as the animal may die due to the maggots tunnelling into their brain or vital organs (depending on the site of the wound), blood loss or
secondary infections.

Case History and Observations
In Ri-Bhoi district Meghalaya, a case of head injury in an eight years old male dog weighing 20 kg was presented with a history of severely bitten by another dog, while fighting, which resulted in open wound on the
head. The wound was further aggravated by scratching and shaking of the head. The dog
became weak and developed anorexia due to the apparent pain caused by the injury. On examination, the respiration and pulse rate were within the normal range while the body temperature was higher (1030 F) than the
normal range. Maggots were also seen in the wound. However, the skull was found to be intact and no neurological symptom was observed. So the case was tentatively diagnosed as traumatic wound on the head with maggots and treatment was aimed at the maggoted wound and prevention of the
secondary brain injury.

Treatment
The initial treatment was started by removing the dead tissues and maggots from the wound. The wound was first cleaned with normal saline solution and dead tissues were removed manually using a pair of artery forceps. To kill the deeply burrowed maggots, cotton balls soaked in turpentine oil were inserted directly into the wound for 30
minutes. Then after removing the cotton balls, the dead maggots were removed mechanically. Ivermectin was injected subcutaneously @ 0.3 mg/kg body weight to kill deep seated maggots. The wound was cleaned with povidone iodine solution three times daily to maintain aseptic condition and fly repellant was applied to prevent from flies. Systemic broad spectrum antibiotic Ceftriaxone @ 25mg/kg body weight was given intramuscularly for 5 days to combat bacterial infection and NSAID, Meloxicam was injected intramuscularly @ 2ml for 5 days to relieve pain and inflammation. A pet cone made from plastic was applied on the neck to prevent scratching of the head. Liver tonic syrup @ 5ml twice daily orally was given as supportive treatment to improve the
appetite of the dog during the treatment. The wound was left open and regularly cleaned with antiseptic solution and topical gel was applied till the wound dried up.

Results and Discussion
In 20 days the wound was dried up and healed completely. Generally, the maggot wounds are treated by removing maggots mechanically or by application of wound cleansing agents and/or a combination of both
followed by general wound management as also recommended by Malik et al., (2014). In our case, turpentile oil application into the wound followed with Ivermectin injection s/c were given to kill both the deeply burrowed
maggots as well as freshly hatched larva from the eggs. As bacterial infection can delay wound healing. A course of broad spectrum systemic antibiotic therapy along with topical antiseptic (povidone iodine) application were
also done to combat bacterial infection and to hasten healing process. NSAID injection i/m for 4 days was also provided for relieving pain. Fly repellent ointment was used several times a day as per need to keep the wound
safe from maggot re-infestation. The dog recovered from the traumatic wound
eventually.

Conclusions
Successful management of traumatic wound with maggots on the head of a dog is possible with proper treatment protocol and utmost care with adequate management.

References
Day, J.F., Edman, J.D., Kunz, S.E., and Wike -l, S.K. (2000). Direct Injury: phobias, psychoses, annoyance, allergies toxins venoms and myiasis, in Medical Entomology : A Textbook on Public Health and Veterinary Problems caused by Arthropods, (B.F. Elidridge and J.D. Edman Eds.), Kluwer Academic Publishers, Dordrect, Netherlands. Pp. 99–150.

Holt, D.E., and Griffin, G.M. (2000). Bite wounds in dogs and cats. Vet. Clin. North. Am. Small Anim. Pract., 30: 669-679. Kelly, P.J., Mason, J.E. and Matthewman, L.A. (1992). Pathogens in dog bite wounds in dogs in Harare, Zimbabwe. Vet. Rec., 131: 464-466.

Rafee, M.A., Amarpal, Kinjavdekar, P. and Aithal, H.P. (2014). A Protocol for the Successful Management of Maggot
Wound in Dogs. Indian J. of Canine Practice, 6(2): 141-143.

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